It’s a Stitch Up

It’s the big story this morning all over the British papers – the new killer in our midst – vitamin pills.

Today, a new Cochrane review tells us that guzzling antioxidant vitamin pills ‘do us no good and may be harmful’. The Independent tell us that,

We swallow them by the bucketload at great expense but there is no evidence vitamin supplements do us any good, and they may even be doing us harm, scientists have concluded. In a blow to the multimillion pound dietary supplement industry, a review of 67 randomised trials of vitamin pills has found that far from prolonging life, they may actually shorten it.

This conclusion was the result of a meta-analysis of 232,000 people and confirms earlier findings that taking certain vitamins in high doses may kill us earlier rather than do us good.

Goran Bjelakovic, a visiting researcher who carried out the review at Copenhagen University Hospital in Denmark, added: “We could find no evidence to support taking antioxidant supplements to reduce the risk of dying earlier.” If anything, people given the antioxidants beta-carotene, vitamin A, and vitamin E showed increased rates of mortality.””The bottom line is that current evidence does not support the use of antioxidant supplements in the general healthy population or in patients with certain diseases.”

[the researchers] warn healthy people who take antioxidant supplements, including vitamins A and E, to try to keep diseases such as cancer at bay that they are interfering with their natural body defences and may be increasing their risk of an early death by up to 16 per cent.

Pamela Mason, of the industry-backed Health Supplements Information Service, said: ‘Antioxidant vitamins, like any other vitamins, were never intended for the prevention of chronic disease and mortality.

‘They are intended for health maintenance on the basis of their various physiological roles in the body and in the case of antioxidant vitamins, this does, in appropriate amounts, include a protective antioxidant effect in the body’s tissues.

So, the vitamin industry has been telling us that their pills are not to prevent disease and death? That is news. But somehow without preventing disease and death they assist ‘health maintenance’? Does that mean I could die but still be in ‘optimum health’?

Patrick Holford, vitamin pill entrepreneur responds.

But Patrick Holford, a nutritionist who has formulated some [sic] supplements for the firm Biocare, said the Cochrane review was a “stitch-up”. He added: “Antioxidants are not meant to be magic bullets and should not be expected to undo a lifetime of unhealthy habits. But used properly, in combination with eating a healthy diet, getting plenty of exercise and not smoking, antioxidant supplements can play an important role in maintaining and promoting overall health.”

there is a campaign by the medical establishment to discredit their products and their role in optimising health.

and

Mr Holford said the review was ‘a stitch-up’ because all the studies were chosen strictly for reducing mortality, and not for the many advantages reported in other studies.

The quackometer would like see his evidence for any of his remarks. Just why a secretive cabal of the ‘medical establishment’ wants to discredit vitamin pills is not explained. It is paranoia and conspiratorial thinking. And isn’t it a perfectly legitimate exercise to ask if chomping pills allows us to live longer? What is Holford saying? That we might lives shorter lives while scoffing his wares, but at least we will be in ‘optimum health’?

But there may well be good reasons to try to discredit vitamin pill salespeople like Holford. Guzzling pills has more insidious effects that a possible reduction in lifespan. Vitamin pills are seen as a shortcut to health – a quick fix to make up for shortcomings or excesses elsewhere. Spending a fortune on pills and focusing on supplementation means that the importance of good diet is marginalised. The quackometer has long supported the view that we should ‘eat food’.

What is somewhat frustrating about all of this is that the original Cochrane paper is not yet up for reading on their web site. All we have is press reports from press releases. This has not stopped Patrick Holford reviewing and rubbishing the work on his web site.

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9 Comments on It’s a Stitch Up

Patrick Holford was on ‘Today’ on Radio 4 this morning at around 08:40. It should be on the BBC ‘Listen again’ soon. I didn’t catch the name of the lady he was put up against but she wasn’t happy with what he was saying but he seem to get the most airtime.

It is important to look at the totality of the data. Goran’s Copenhagen group published a similar meta-analysis in JAMA last year which also showed that when high doses of fairly arbitrary combinations of a small number of micronutrients are taken in supplement form, there is an increase in mortality just over the threshold of statistical significance. This case now looks quite strong, and it is shortsighted (to put it mildly), for supplement salespeople to deny it.

However, it is unarguable that a diet rich in vitamins and phytonutients is associated with better health and life expectancy. It is also well documented that for us urbanised suckers, living at around 2,200 Kcals/day and making poor food choices to boot, dysnutrition a.k.a. Type B malnutrition is rife. (Check out the latest National Diet & Nutrition Surveys @ HMSO).

So, why do supplements not help, and even do harm? The answer is glaringly obvious, and is that today’s supplements are apallingly badly designed. Instead of making any attempt to ‘remedy the defects of the modern diet’, as the vitamin companies suggest, the content of these pills reflects merely what the hucksters think they can market, at profitable price points.

Yes, we should all be eating a well-balanced diet. But let’s be realistic; living as we do at a calorific throughput not very far above BMR, it has become impossible to obtain all the micro- and phyto-nutrients we need for good health even from a well-balanced diet.

This argument has been made in a number of publications, and will be extended in a series of three articles in an UK-based 5-star medical journal, starting in July (I think). If you’re interested, have a look and then let the real battle commence!

I thought the HSIS spokesperson was a bit naughty to suggest that millions of people cannot get sufficient vitamins from food.

I also thought this quote from Holford was interesting: “in combination with a healthy diet full of fruit and vegetables, getting plenty of exercise and not smoking, antioxidant supplements can play an important role” – if you have a healthy diet full of fruit and veg then antioxidant supplements are completely unnecessary.

Last night on Newsnight Peter Melchett told the hoary old lie: ‘inorganic food causes widespread health problems’. I must have missed the dramatic rise in mortality rates as a result of this. Also the large reduction in global population as people adopt Western style diets eating ‘inorganically’ produced food. I wonder where he thinks the food scarcity they were discussing comes from?

The man is a joke and should not be on TV. Mind you the Green movement increasingly sees us humans (other than themselves of course) as the problem so are rubbing their hands with glee at the rising food prices and starvation that will result. Bastards.

Like all these trials the interesting news is in what isn’t published by the media.

The ‘new’ study isn’t new at all. It was first published in the Journal of the American Medical Association (JAMA) in February last year. The only difference is that the ‘new’ Cochrane review includes one less study. So the anti-nutritional lobby has had strong press coverage twice from the same data.

Despite its claims to be an independent review, the Cochrane study excluded 405 studies into vitamins because there were no deaths, and another 69 because they weren’t ‘randomised’ trials. As it is, the review looked only at studies that involved sick people, taking very high-dose synthetic vitamins, and which had participants dying. This does not replicate average use, and does not give the researchers the authority to claim that supplements shouldn’t be taken by healthy people.

When you select or reject studies on criteria that only mean something to statisticians, and ignore important things like duration, how long the study ran for — which ranged from 28 days to 14 years — your findings are immediately meaningless. Even the huge difference in dose of supplements between different studies — Vitamin E ranging from 10 to 5000 units daily, for instance — they didn’t deem important.

The studies look only at synthetic vitamins, and did not include those that are sourced from plants, such as flavonoids, anthocyanins, and sulforaphanes, which are included in leading-edge supplements, usually produced by small independent companies.The review flies in the face of many other studies that have established that high-dose vitamins are effective in reducing the risk of lethal diseases, such as cancer and heart disease.

How ironic the media are pushing this information at the same time the european commission is ready to ban many vitamin supplements and codex alimentarius is coming into sight.

Antony, you are very good at using copy and paste from the deceitful “What Doctors Don’t Tell You’ web site. Well let me tell you What Doctors Don’t Tell You Don’t Tell you.

Firstly, the authors have re-worked their data according to Cochrane Library rules. This is a perfectly legitimate thing to do as the analysis can then be added to the library. The fact that such a study has now passed the rigorous and independent standards of Cochrane is very newsworthy. This is as good as it gets.

The authors excluded studies where deaths were not recorded as they wanted to make mortality their main outcome measurement. This is perfectly reasonable as deaths are hard to fudge. Their is no subjective experience of death in a trial. It happens to a participant or it does not. It should make any results free from lost of potential biases.

The selection criteria were ‘healthy patients’ and those ‘diagnosed with specific diseases in a stable phase’. Read the paper yourself, rather than the WDDTY propaganda.

The criteria for selection were to do with sources of bias. That is, trails that were observational were excluded or did not have sufficient blinding or randomisation. That is perfectly legitimate and does not take a PhD in statistics to understand. Some trials may have been more sensitive, due to duration or dose, but all added to the pool of data. Holford argued that the study excluded too many trails. Which way do you want it? Too many trials or too few?

The trial restricted itself to common antioxidants found in all high streets. That i quite a valid thing to do. Looking at esoteric concoctions plugged by pill manufacturers will have to be for another study. Their exclusion does not invalidate the result here.

The review may well fly in the face of many studies. But you have to remember that this is a meta analysis of many studies where poor quality trials were excluded as they would introduce bias. If there are many poor quality studies out there reporting positive results, well now we know.

Why should the media be pushing this? Are you saying there is a conspiracy? You might like to provide evidence.

Antony, yor reaction is typical of the food pill industry. It is a huge industry that flogs useless (and even dangerous) pills to people who are told it is vital for their health. It is totally dishonest industry and run by the Big Pharma companies. Holland and Barrett is one of the top 20 US pharma companies. Boots, one of the leasing supllier of food pills in the UK, is one of our biggest pharma companies. Everywhere you looked yesterday, you saw vested interests trying to rubbish this work. All with stupid, dissembling arguments, like these WDDTY idiocies that you cut and paste.

It’s a dishonest business and yesterday may start to see the downturn of it.

Normal people in the UK are not malnourished or lacking in nutrients as a rule as far as I’m aware. The body is very clever at getting nutrients out of even the rubbishest of foods, plus foods such as bread are fortified.